How much rates vary
Facilitymedian $2,344 · 10th to 90th $741 to $8,318Professionalmedian $724 · 10th to 90th $575 to $1,148
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $602.56 Median $741.31 Typical High $1,288.25 | Facility | None | $602.56 | $741.31 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,071.52 | Professional | None | $588.84 | $707.95 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $645.65 Typical High $870.96 | Professional | None | $41.69 | $645.65 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $9,332.54 | Facility | None | $954.99 | $2,884.03 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,071.52 | Professional | None | $575.44 | $724.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,071.52 Typical High $1,584.89 | Professional | 50 · Both sides | $870.96 | $1,071.52 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $457.09 Typical High $676.08 | Professional | 62 · Two surgeons | $363.08 | $457.09 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $114.82 Typical High $169.82 | Professional | 80 · Assistant surgeon | $93.33 | $114.82 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $100.00 Typical High $147.91 | Professional | AS · PA/NP assist | $81.28 | $100.00 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $8,128.31 | Facility | None | $645.65 | $1,047.13 | $8,128.31 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,071.52 | Professional | None | $602.56 | $851.14 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,862.09 Typical High $5,754.40 | Facility | None | $794.33 | $1,862.09 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $4,570.88 | Professional | None | $676.08 | $870.96 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $478.63 | Professional | None | $33.11 | $33.11 | $478.63 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,258.93 | Professional | None | $676.08 | $831.76 | $1,258.93 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $346.74 Typical High $436.52 | Professional | 52 · Reduced service | $302.00 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $120.23 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $645.65 | Professional | 54 · Surgery only | $457.09 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $131.83 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $602.56 |
Where Kentucky sits
The same service costs 6.1 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $13,882MT $2,270
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.